작업관련성 요통환자를 위한 복합운동 프로그램이 신체적 기능회복과 우울 및 불안감에 미치는 영향

Abstract

복합운동프로그램의 적용이 작업관련성 요통환자의 건강체력, 측만도, 우울, 불안 및 요통장애지수에 미치는 영향을 알아보기 위하여 G광역시소재 K산업체 근로자 중 근로복지공단에 산재요양을 신청하여 운동 재활 프로그램 참여자로 인정된 작업관련성 요통환자 총 79명(남)을 대상으로 복합운동 프로그램과 교육을 실시하였다. 운동프로그램은 주(5)회 진행하였으며 8주 동안의 복합운동 실시 전과 후의 건강체력 측만도, 우울 불안 및 요통장애지수의 차이변화를 살펴보아 다음과 같은 결론을 얻었다. 1.1.1. 건강체력 1.1.1.1. 작업성 요통환자의 신체구성에 있어 체중의 변화는 1, 2, 3차 집단은 감소하였고 4차 집단은 증가하여 전체적으로 증가하여 유의한 차이가 없었으며 체지방의 변화에서도 1, 2, 3차 집단은 감소하였고 4차 집단은 증가하여 전체적으로 증가하여 유의한 차이가 없었다. 1.1.1.2. 순환기 및 심폐기능의 변화에서는 안정 시 심박수의 경우 1차 집단은 감소하였으나 2, 3, 4,차 집단은 증가하여 전체적으로 증가하였고 폐활량의 경우 1, 2, 3차 집단은 감소하였으나 4차 집단은 크게 증가하여 전체적으로 증가하여 유의한 차이가 나타났다. 또한 %폐활량의 경우에서도 1, 2, 3차 집단은 감소하였고 4차 집단은 증가하였으나 전체적으로 감소하여 통계적으로 유의한 차이가 나타났다. 1.1.2. 체력측정 변화 1.1.2.1. 심폐지구력에서 최대산소섭취량의 경우는 1차 집단은 감소하였으나 2, 3, 4,차 집단은 증가하여 전체적으로 36.07±1.78ml/kg/분에서 37.11±1.48ml/kg/분으로 증가하였다. 1.1.2.2. 근력에 있어서 배근력의 경우는 모든 집단이 증가하였으며 특히 1차 집단에서 크게 증가하여 나타났고 전체적으로는 92.93±5.77kg에서 113.88±14.99kg으로 크게 증가하여 나타났다. 악력의 경우 1, 2, 3차 집단은 증가하였으나 4차 집단은 감소하여 전체적으로 45.70±2.01kg에서 47.10±2.08kg으로 증가한 것으로 나타났다. 1.1.2.3. 유연성에 있어서 앉아윗몸앞으로 굽히기의 경우 모든 집단이 증가하여 유의한 차이가 나타났으며 전체적으로 7.34±8.73cm에서 13.00±6.32cm로 크게 증가하여 유의한 차이가 나타났다. 1.1.2.4. 근지구력에 있어서 윗몸일으키기의 경우는 모든 집단이 증가하여 유의한 차이가 나타났으며 전체적으로 14.50±1.38회에서 18.43±1.46회로 증가하였다. 엎드려팔굽혀펴기의 경우도 모든 집단이 증가하여 유의한 차이가 나타났으며 전체적으로 21.69±1.24회에서 27.64±3.31회로 증가하여 유의한 차이가 나타났다. 1.1.2.5. 순발력에 있어서 제자리높이뛰기의 경우 모든 집단이 증가하여 유의한 차이가 나타났으며 전체적으로 38.69±3.05cm에서 43.14±3.59cm로 증가하여 유의한 차이가 나타났다. 1.1.2.6. 민첩성에 있어서 사이드스텝의 경우 모든 집단이 증가하여 전체적으로 30.62±1.19회에서 34.34±2.99회로 증가하였으며 전신반응의 경우는 1, 2, 4,차 집단은 감소하였으나 3차 집단은 증가하여 전체적으로는 257.32±10.75m/sec에서 232.96 ±17.82m/sec로 크게 증가하여 나타났다. 1.1.2.7. 평형성에 있어서 눈감고외발서기의 경우 모든 집단이 증가하였으며 특히 2차 집단에서 가장 크게 증가하였으며 전체적으로 32.57±6.72초에서 53.79±19.97초로 크게 증가하였다. 1.1.3. 측만도 1.1.3.1. 작업성 요통환자의 복합운동 실시 후 측만도의 변화에서 경추부 만곡각도는 전체적으로 9.25±2.75도에서 5.35±4.54도로 감소되어 교정된 것으로 나타났다. 1.1.3.2. 작업성 요통환자의 복합운동 실시 후 측만도의 변화에서 흉추부 만곡각도는 전체적으로 7.37±0.41도에서 5.06±0.61도로 감소되어 교정된 것으로 나타났다. 1.1.3.3. 작업성 요통환자의 복합운동 실시 후 측만도의 변화에서 요추부 만곡각도는 전체적으로 6.62±1.04도에서 4.07±1.65도로 감소되어 교정된 것으로 나타났다. 1.1.4. 요통장애지수 작업성 요통환자의 복합운동 전과 후 요통장애 변화는 실험 후 진통제 사용, 들기, 앉기, 외출, 사회생활, 성생활, 거동, 통증지속시간, 통증발생빈도, 동작 작업에 따른 통증에서는 감소되어 나타났고 걷기, 수면, 서기에서는 증가되어 나타났다. 1.1.5. 우울 및 불안 1.1.5.1. 작업성 요통환자의 복합운동 실시 후 우울 점수는 1차 집단은 감소한 것으로 나타났으며 2, 3, 4차 집단은 특별한 변화가 없었다. 1.1.5.2. 작업성 요통환자의 복합운동 실시 후 불안 점수의 경우 1, 2차 집단은 감소한 것으로 나타났고 3, 4차 집단은 증가되어 나타났으나 전체적으로 감소하였다. 본 연구에서는 작업관련성 산재요통 환자들에게 복합운동 프로그램을 실시한 후 우울과 불안의 결과에서는 선행연구들과 일부 다르게 나타났고 건강 체력과 측만도에서는 유의하게 개선된 것으로 나타났고 요통정도도 감소되어 나타난 바 이와 같은 결과는 복합운동 프로그램이 작업관련성 요통환자들의 문제점을 개선하는데 효과적이고 적합하다는 사실을 알 수 있었다.|The aim of this research is to find out the influence of a combined exercise program on the physical stamina, bodily measures, depression and anxiety of patients affected with work related back pain. In this study 79 male workers in K Industry in G City were programmed for a combined exercise program and education. They had applied for the medical treatments in Korea Labor Welfare Corporation to be admitted as participants in exercise rehabilitation program because of work-related back pain. The exercise program was implemented three to five times a week and the changes in physical stamina, severity of scoliosis, depression, and anxiety before and after the exercise program for eight weeks were examined. The results of the test can be summarized as follows: A) Physical Stamina 1) The body weights of the patients with work-related back pain was reduced in 1st, 2nd, and 3rd groups, but remained fairly consistent in 4th group. The body fat also was reduced in 1st, 2nd, and 3rd groups and remained consistent in 4th group. 2) The changes in circulatory organs and cardiopulmonary functions showed that the heart beat was decreased for 1st group, but increased for 2nd, 3rd, and 4th groups in tranquility and that the heart rate was decreased for 1st, 2nd, and 3rd groups, but increased greatly for 4th group. Also, heart rate percentage (%) was decreased in 1st, 2nd, and 3rd groups, but increased significantly for 4th group. B) Bodily Measures 1) In consistency with cardiopulmonary functions, the maximum oxygen intake was decreased in 1st group, but increased in 2nd, 3rd, and 4th groups, showing overall increase from 36.07±1.78ml/kg/min to 37.11±1.48ml/kg/min. 2) In muscular strengths, all groups showed improvement in back muscle strength, but the improvement was particularly significant in 1st group. Overall, the increase was from 92.93±5.77kg to 113.88±14.99kg. Grasping power was increased in 1st, 2nd, and 3rd groups, but was decreased in 4th group, showing overall increase from 45.70±2.01kg to 47.10±2.08kg. 3) In physical flexibility, all groups showed improvement in doing stretching forward in seated position, showing a great overall increase from 7.34±8.73cm to 13.00±6.32cm. 4) In muscular consistency, all groups showed significant improvement in doing sit-ups, showing overall increase from 14.50±1.38times to 18.43±1.46 times. All groups also showed great improvement in doing push-ups, showing overall increase from 21.69±1.24times to 27.64±3.31times. 5) In instant speed, all groups showed great increase in high-jumping, showing overall increase from 38.69±3.05cm to 43.14±3.59cm. 6) In agility, all groups showed great improvement in side-stepping, showing overall increase from 30.62±1.19times to 34.34±2.99times. In whole-body reaction, all groups except for 3rd group showed decrease in performance. Overall, the decrease was from 257.32±10.75m/sec to 232.96±17.82m/sec. 7) In balance, all groups showed improvement in standing with one foot with eyes closed. The 2nd group showed greatest increase and the overall increase was from 32.57±6.72sec to 53.79±19.97sec. C) Severity of Scoliosis 1) After the combined exercise, the cervical curvature was greatly corrected from 9.25±2.75degree to 5.35±4.54degree overall. 2) After the combined exercise, the thoracic curvature was greatly corrected from 7.37±0.41degree to 5.06±0.61degree overall. 3) After the combined exercise, the lumbar curvature was greatly corrected from 6.62±1.04degree to 4.07±1.65degree overall. D) Severity of Back Pain The changes in the severity of back pain after the combined exercise for the patients with work-related back pain revealed that the patients experienced less pain after taking pain killers and while lifting objects, sitting down, doing social activities, engaging in sexual activities, and performing various movements and that they saw decrease in the duration and frequency of pain and in the severity of pain during work. However, the severity of back pain was increased while walking, sleeping, and standing. The changes in the severity of back pain after the combined exercise for the patients with work-related back pain revealed that the patients experienced less pain after taking pain killers and while lifting objects, sitting down, doing social activities, engaging in sexual activities, and performing various movements and that they saw decrease in the duration, frequency and severity of pain during work. However, the severity of back pain was increased while walking, sleeping, and standing. E) Depression and Anxiety 1) After the combined exercise for the patients with work-related back pain, 1st group showed lower scores in the depression test, but 2nd, 3rd, and 4th groups did not see any progress. 2) After the combined exercise for the patients with work-related back pain, 1st and 2nd groups showed lower scores in the anxiety test, but 3rd and 4th groups showed higher scores. It was found that results of depression and anxiety tests are slightly different from the results of preceding studies, but the results of physical stamina and severity of scoliosis showed significant changes. As the severity of back pain showed great decrease in pain, we can conclude that the combined exercise program is satisfactorily effective and suitable as an exercise program for the patients with work-related back pain.